THE DEVIL IS IN THE DETAILS: RED DE PROTECCIÓN SOCIAL AND MATERNAL HEALTH SERVICE UTILIZATION IN NICARAGUA

Abstract

Conditional cash transfer (CCT) programs have been steadily gaining popularity as a policy tool for alleviating poverty through a cash benefit and conditions promoting human capital acquisition for children in order to break the intergenerational transmission of poverty. Due to their documented success at improving health and education outcomes, attention has turned to whether there are also positive externalities leading to other potential applications of these programs, and maternal health service utilization is one area of interest. Through the careful examination of CCT programs and their impact on maternal health service utilization policymakers can learn about which policies have an impact and use the knowledge to inform future program design. This analysis uses data from an impact evaluation of the pilot Red de Protección Social program in Nicaragua and follows the framework established by de Brauw and Peterman (2011) examining whether the program had a positive impact on four components of maternal health service utilization: prenatal care, skilled presence at birth, institutional birth and postnatal care. The results of an OLS regression and a difference in difference regression show that the program had no significant impact on any of the outcomes of interest. This suggests that general CCT programs might not improve maternal health outcomes and future research on the mechanisms through which CCT programs impact maternal health service utilization is needed.